ALA Gives White House Low Marks for Full Tobacco Control

Long wait to give FDA authority over all tobacco products called "frustrating"

The Obama administration has received an "incomplete" grade from the American Lung Association (ALA) for being too slow to grant the FDA regulatory authority over e-cigarettes and other noncigarette tobacco products.

"As of January 31, 2016, the Obama Administration had not yet given the U.S. Food and Drug Administration (FDA) oversight authority over all tobacco products. Given this pending final rule has concluded the 90-day review period at the Office of Management and Budget at the White House and could be released at any time, the federal government earns an 'I' for Incomplete in this category," the ALA stated in a new report.

In its "State of Tobacco Control 2016" report, the association urged the administration to quickly enact the long-delayed "deeming rule," which will extend provisions of the federal Tobacco Control Act to e-cigarette and all other tobacco products.

"The Obama Administration must finalize the regulation giving the FDA authority over all tobacco products so that FDA can begin to protect our nation's youth and the public health from the dangers of e-cigarettes, cigars, hookah, little cigars and other tobacco products," the report stated.

The finalized deeming rule is widely expected to be made public within the next few weeks, but Thomas A. Carr, ALA director of national policy, said the now 5-year wait for regulation has been frustrating.

"At the state level we saw some promising action on tobacco taxes last year, but other than that, 2015 was another year of policymakers just not doing what they needed to do to combat tobacco use," he told MedPage Today.

The ALA report also urged the administration to issue product standards governing the design and content of tobacco products. A major goal of this initiative is to ban the sale of menthol cigarettes, ALA spokeswoman Erika Sward told MedPage Today.

It has been nearly half a decade since the FDA's Tobacco Products Scientific Advisory Committee (TPSAC) recommended the removal of menthol cigarettes from the marketplace, but no action has been taken.

"The committee recognized that menthol cigarettes were more dangerous for smoking initiation," Sward said.

The report also calls on Congress to increase and equalize taxes across all tobacco products.

"We need parity across all tobacco taxes so that there is no financial incentive for people to switch to e-cigarettes or some other tobacco product instead of quit," she said.

Every state, with the exception of Michigan, Pennsylvania, and the District of Columbia, has enacted laws banning the sale of e-cigarettes to minors, but very few states have included e-cigarettes in their smoke-free air laws aimed at reducing secondhand smoke exposure, Sward said.

While teen cigarette smoking rates have declined dramatically in the U.S. in just a few short years -- by almost 42% since 2011 among high school students -- this has been offset by an equally dramatic increase in the use of e-cigarettes and other noncigarette tobacco products including flavored little cigars and hookah.

According to the report, nearly a quarter of U.S. high school students (24.6%) reported having used at least one tobacco product, and more than 50% of these teen users report using two or more tobacco products.

The reported noted that the "significant increase in the use of some tobacco products threatens to undermine the United States' overall progress in the fight against tobacco-caused death and disease."

Sward said the proliferation of fruit- and candy-flavored e-cigarettes, as well as other as yet unregulated tobacco products, is aimed directly at teens, even though the tobacco industry claims to market only to adults.

"The e-cigarette industry has really ripped the pages from 'Big Tobacco's' playbook," she said. "So we are seeing the glamorization of e-cigarettes through the use of celebrities, we are seeing the candy and fruit flavors, and we are seeing cartoons in advertisements and even television ads."